This is my first post in a series about joint degrees in medicine and social sciences, in response to frequently asked questions from undergraduates.

Introduction

As an MD-PhD student, I frequently get asked to speak to younger students about graduate school.  Students concerns are often as follows. They know they want to go to medical school and study social sciences. But should they pursue a master’s degree or a PhD in the social sciences? They find it hard to tell the difference (and justifiably – they haven’t pursued either yet).

I confess that when I applied to graduate school, I thought that a PhD was just a Master’s with 2+ years of research tacked on (it is definitely not). Now that I am a little older and wiser, I wanted to share what I wish I had known when I applied. In particular, I will focus on the key differences between a master’s and a PhD when combined an MD. I will also discuss what students should consider when choosing between the two.

About me:

As an undergraduate, I knew I wanted to study medicine, but I also loved my economics courses. I also saw the two fields as closely related – many of the biggest issues in medicine were problems of economics.  In a world with extensive need, how do we (and how should we) allocate finite resources?

At the time, I found the internet awash with information (and opinions) about whether people should go to medical school. But I found almost no information for students like me, someone interested in both medicine and social sciences. Compared to the volume of conversation about medical school, the silence was frustrating.   I agonized a great deal about whether to pursue an MD-PhD or an MD only (with the possibility of a master’s degree).  At the time, I made my best guess as to the right choice and took the plunge. I started an MD-PhD program with a PhD in applied economics at the University of Chicago. Now, I am grateful to the mentors who helped guide me in this direction, and I know that I made the right decision for me.

So now that I know more, I wanted share what I have found to be the salient differences and important considerations when choosing between paths that involve both medicine and the social sciences (MD/PhD or MD/master’s):

Important Differences:

Coursework:  PhD coursework is typically more advanced than master’s coursework. Most master’s courses assume students are new to the field and cover topics at an introductory level. For example, the master’s-level economics courses in my department were similar to my undergraduate classes. As someone who majored in economics, those classes would have been a repeat of material I already knew. However, I know some students who felt these classes greatly expanded their horizons, in part because they were new to the subject.

In contrast, my PhD coursework assumed a strong foundation in math, statistics, and undergraduate economics. It was focused on developing a relatively specialized research skillset that would allow me to meaningfully advance the state of knowledge.

These classes would have been a poor fit for someone who wanted an introduction to the field or a bird’s eye view of topics. However, I found these classes to be deeply engaging and intellectually formative.

Stress Level: A master’s is generally less stressful than a PhD. I know multiple medical students who say that their time in a master’s or MPH program was quite relaxed compared to their medical school years. In contrast, a PhD is often no less stressful than medical school, albeit for completely different reasons. Unlike medical school, a PhD doesn’t require memorizing extremely large volumes of material. However, it does require answering a question that no one else has ever answered before (and there is usually a substantive reason why no one has answered the question before). I find that medical school involves much more day to day angst (“How am I going to memorize all these pathways by tomorrow?!?”) and a PhD involves more long-term angst (“Is my research project going to matter to anyone??”).

Application Timing: With PhDs, earlier is better.  With a master’s, later is better.

There are large benefits to applying to MD-PhD programs concurrently with medical school – namely the possibility of funding for medical school.  While I know people who pursued PhDs after starting medical school, they bore much or all of the cost of medical school.

In contrast, there are large benefits to delaying pursuit of a master’s. First, some residencies will fund them, saving you a lot of tuition dollars. Second, a master’s degree will be much more valuable if you have a clear focus area and know what skills you want to learn. A year spent developing a particular expertise is much more useful than a year spent taking a smorgasbord of introductory classes.

Costs:  The relative costs depend substantially on the particulars of the tuition, funding and length of the programs as well as your specialty choice. An MD-master’s is generally not funded but takes less time. An MD-PhD is generally funded but takes several years longer. As a result, the sticker price of an MD-PhD is lower (no tuition!), but the opportunity cost is much, much higher (3-6 years of physician salary).   In terms of ROI, the best choice is a 4-year joint MD-MBA at good public school followed by a residency in a competitive specialty (by my back-of-the-envelope math). However, a funded MD-PhD compares quite favorably to medical school and a master’s degree at a private school.

Expertise: At the end of a master’s program, you should have a broad working knowledge of a field. At the end of a PhD program, you should have a deep expertise in several highly specific topics.

Disciplinary vs Interdisciplinary: Professional master’s programs, such as MPPs and MPHs, are often quite interdisciplinary, with students taking introductory classes from experts in a variety of fields. In contrast, a PhD is a disciplinary endeavor. One becomes an expert in the methods, past work, and ways of thinking in one field (maybe two).

Type of Research: As an MD, you can be the principle investigator on a study without a PhD. You will approach questions as a doctor first. The novelty in your research will come from the questions you ask.

In contrast, as an MD-PhD, your research will be highly oriented towards the discipline you trained in. You will approach questions as an economist/anthropologist/etc. Hopefully, you will innovate in terms of methods and rigor applied to the question (and you will care a lot about methods, to an extent which will irritate your medical colleagues).

Goals: Master’s programs explicitly prepare students for work in variety of roles, including business, government, administration, etc. For example, an MD-MBA would prepare someone to become a hospital administrator or a healthcare entrepreneur. Similarly, an MD-MPH would prepare someone to work in an NGO or a government public health department.

In contrast, PhD programs intended to train students to become researchers. Of course, the skills learned in a PhD can be used in many settings like NGOs and think tanks. But the goal held up by your mentors and peers will be to become an independent researcher in an academic setting.

 

To summarize:

• Do an MD-PhD if you want to become an expert in a social science discipline and are happy to give up several years of being a full-fledged physician to do this.
• Do a master’s degree if you want to be doctor first and foremost, but also develop business/public health/policy skills.
• Consider the finances of each choice and plot your course to optimize these.

Ultimately, the right choice also depends on your vision of a rewarding professional life. Both choices offer many wonderful opportunities to learn, grow, and do meaningful work.